Organization
WAUBONSIE MENTAL HEALTH CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN SHOTWELL (EXECUTIVE DIRECTOR)
(712) 542-2388
Entity
Organization
Contact information
Practice address
216 W DIVISION ST, CLARINDA, IA 51632-2509
(712) 542-2388
(712) 542-2984
Mailing address
216 W DIVISION ST, CLARINDA, IA 51632-2509
(712) 542-2388
(712) 542-2984
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017244
—
IA
05
—
0229419
—
IA
05
—
0299446
—
IA
Enumeration date
01/24/2007
Last updated
02/06/2019
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